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Maison N, Omony J, Rinderknecht S, Kolberg L, Meyer-Bühn M, von Mutius E, Hübner J, von Both U. Old foes following news ways?-Pandemic-related changes in the epidemiology of viral respiratory tract infections. Infection 2024; 52:209-218. [PMID: 37644253 PMCID: PMC10811157 DOI: 10.1007/s15010-023-02085-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/13/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION Following lockdown periods and restricting public health measures in response to the COVID-19 pandemic, respiratory tract infections (RTIs) rose significantly worldwide. This led to an increased burden on children's hospitals compromising medical care of acutely and chronically ill children. We characterized changes in the epidemiological pattern of circulating respiratory viral infections. METHODS We assessed the number of patients with RTIs and the annual distribution of virus detections between 2019 and 2022 based on 4809 clinical samples (4131 patients) from a German pediatric tertiary care-center. We investigated the impact of lockdown periods on spectra of circulating respiratory viruses, pattern of coinfections, age, and seasonality of infections. RESULTS A fourfold increase in the number of respiratory virus detections was observed in 2022 vs 2019 with numbers doubling in 2022 (vs 2021). In 2022, seasonal patterns of circulating virus, particularly Adeno and seasonal Coronavirus were far less pronounced compared to previous years, in fact almost disappeared for Rhinoviruses.". SARS-CoV-2, Parainfluenza- and human Metapneumovirus detections increased significantly in 2022 (2019 vs 2022, p < 0.01). Coinfections with multiple viruses occurred more frequently since 2021 compared to pre-pandemic years, especially in younger children (2019 vs 2022, p < 0.01). CONCLUSION Compared to pre-pandemic years, we observed a dramatic increase in pediatric RTIs with an incrementing spectrum of viruses and a predominance in Rhino/Enterovirus infections - leading to a high rate of hospital admissions, particularly in conjunction with other viruses. This caused an acute shortage in medical care and may also be followed by an increase of virus-triggered secondary chronic respiratory diseases like asthma-rendering a burden on the health system.
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Affiliation(s)
- Nicole Maison
- Department for Asthma and Allergy, Dr Von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Lindwurmstr. 4, 80337, Munich, Germany.
- Institute for Asthma- and Allergy Prevention (IAP), Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany.
- German Center for Lung Research (DZL), Munich, Germany.
| | - Jimmy Omony
- Institute for Asthma- and Allergy Prevention (IAP), Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany
| | - Sophia Rinderknecht
- Department for Asthma and Allergy, Dr Von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Lindwurmstr. 4, 80337, Munich, Germany
| | - Laura Kolberg
- Department of Infectious Diseases, Dr Von Hauner Children's Hospital, LMU University Hospital, LMU, Munich, Germany
| | - Melanie Meyer-Bühn
- Department of Infectious Diseases, Dr Von Hauner Children's Hospital, LMU University Hospital, LMU, Munich, Germany
| | - Erika von Mutius
- Department for Asthma and Allergy, Dr Von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Lindwurmstr. 4, 80337, Munich, Germany
- Institute for Asthma- and Allergy Prevention (IAP), Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany
- German Center for Lung Research (DZL), Munich, Germany
| | - Johannes Hübner
- Department of Infectious Diseases, Dr Von Hauner Children's Hospital, LMU University Hospital, LMU, Munich, Germany
| | - Ulrich von Both
- Department of Infectious Diseases, Dr Von Hauner Children's Hospital, LMU University Hospital, LMU, Munich, Germany
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
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Peden DB. Respiratory Health Effects of Air Pollutants. Immunol Allergy Clin North Am 2024; 44:15-33. [PMID: 37973257 DOI: 10.1016/j.iac.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Air pollution is a risk factor for asthma and respiratory infection. Avoidance of air pollution is the best approach to mitigating the impacts of pollution. Personal preventive strategies are possible, but policy interventions are the most effective ways to prevent pollution and its effect on asthma and respiratory infection.
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Affiliation(s)
- David B Peden
- Division of Pediatric Allergy & Immunology and, Center for Environmental Medicine, Asthma and Lung Biology, The School of Medicine, The University of North Carolina at Chapel Hill, UNC School of Medicine, 104 Mason Farm Road, CB#7310, Chapel Hill, NC 27599-7310, USA.
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Varela-Lasheras I, Perfeito L, Mesquita S, Gonçalves-Sá J. The effects of weather and mobility on respiratory viruses dynamics before and during the COVID-19 pandemic in the USA and Canada. PLOS DIGITAL HEALTH 2023; 2:e0000405. [PMID: 38127792 PMCID: PMC10734953 DOI: 10.1371/journal.pdig.0000405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/07/2023] [Indexed: 12/23/2023]
Abstract
The flu season is caused by a combination of different pathogens, including influenza viruses (IVS), that cause the flu, and non-influenza respiratory viruses (NIRVs), that cause common colds or influenza-like illness. These viruses exhibit similar dynamics and meteorological conditions have historically been regarded as a principal modulator of their epidemiology, with outbreaks in the winter and almost no circulation during the summer, in temperate regions. However, after the emergence of SARS-CoV2, in late 2019, the dynamics of these respiratory viruses were strongly perturbed worldwide: some infections displayed near-eradication, while others experienced temporal shifts or occurred "off-season". This disruption raised questions regarding the dominant role of weather while also providing an unique opportunity to investigate the roles of different determinants on the epidemiological dynamics of IVs and NIRVs. Here, we employ statistical analysis and modelling to test the effects of weather and mobility in viral dynamics, before and during the COVID-19 pandemic. Leveraging epidemiological surveillance data on several respiratory viruses, from Canada and the USA, from 2016 to 2023, we found that whereas in the pre-COVID-19 pandemic period, weather had a strong effect, in the pandemic period the effect of weather was strongly reduced and mobility played a more relevant role. These results, together with previous studies, indicate that behavioral changes resulting from the non-pharmacological interventions implemented to control SARS-CoV2, interfered with the dynamics of other respiratory viruses, and that the past dynamical equilibrium was disturbed, and perhaps permanently altered, by the COVID-19 pandemic.
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Affiliation(s)
- Irma Varela-Lasheras
- Nova School of Business and Economics, Universidade Nova de Lisboa, Carcavelos, Portugal
| | - Lilia Perfeito
- LIP, Laboratório de Instrumentação e Física Experimental de Partículas, Lisbon, Portugal
| | - Sara Mesquita
- LIP, Laboratório de Instrumentação e Física Experimental de Partículas, Lisbon, Portugal
- Nova Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Joana Gonçalves-Sá
- Nova School of Business and Economics, Universidade Nova de Lisboa, Carcavelos, Portugal
- LIP, Laboratório de Instrumentação e Física Experimental de Partículas, Lisbon, Portugal
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Fedrizzi L, Carugno M, Consonni D, Lombardi A, Bandera A, Bono P, Ceriotti F, Gori A, Pesatori AC. Air pollution exposure, SARS-CoV-2 infection, and immune response in a cohort of healthcare workers of a large university hospital in Milan, Italy. ENVIRONMENTAL RESEARCH 2023; 236:116755. [PMID: 37517490 DOI: 10.1016/j.envres.2023.116755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/01/2023]
Abstract
Several studies have examined the possible relationship between air pollutants and the risk of COVID-19 but most returned controversial findings. We tried to assess the association between (short- and long-term) exposure to particulate and gaseous pollutants, SARS-CoV-2 infections, and immune response in a population of healthcare workers (HCWs) with well-characterized individual data. We collected occupational and clinical characteristics of all HCWs who performed a nasopharyngeal swab (NPS) for detecting SARS-CoV-2 at the Policlinico Hospital in Milan (Lombardy, Italy) between February 24, 2020 (day after first documented case of COVID-19 in our hospital) and December 26, 2020 (day before start of the vaccination campaign). Each subject was assigned daily average levels of particulate matter ≤10 μm (PM10), nitrogen dioxide (NO2), and ozone (O3) retrieved from the air quality monitoring station closest to his/her residential address. Air pollution data were treated as time-dependent variables, generating person-days at risk. Multivariate Poisson regression models were fit to evaluate the rate of positive NPS and to assess the association between air pollution and antibody titer among NPS-positive HCWs. Among 3712 included HCWs, 635 (17.1%) had at least one positive NPS. A 10 μg/m3 increase in NO2 average concentration in the four days preceding NPS was associated with a higher risk of testing positive [Incidence Rate Ratio (IRR) = 1.08, 95% confidence interval (CI): 1.01; 1.16)]. When considering a 1 μg/m3 increase in 2019 annual NO2 average, we observed a higher risk of infection (IRR: 1.02, 95%CI: 1.00; 1.03) and an increased antibody titer (+2.4%, 95%CI: 1.1; 3.6%). Findings on PM10 and O3 were less consistent and, differently from NO2, were not confirmed in multipollutant models. Our study increases the body of evidence suggesting an active role of air pollution exposure on SARS-CoV-2 infection and confirms the importance of implementing pollution reduction policies to improve public health.
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Affiliation(s)
- Luca Fedrizzi
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Michele Carugno
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Lombardi
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessandra Bandera
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Patrizia Bono
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ferruccio Ceriotti
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Gori
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Angela Cecilia Pesatori
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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